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Therapeutic Advances in Cardiovascular Disease
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*Kidney Diseases
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Review

Aldosterone and progression of kidney disease

Monica Cortinovis, Norberto Perico, Dario Cattaneo, and Giuseppe Remuzzi*

Department of Medicine and Transplantation, Ospedali Riuniti di Bergamo – Mario Negri Institute for Pharmacological Research, Bergamo, Italy

* To whom correspondence should be addressed.


  Abstract

Experimental evidence indicates that aldosterone, besides its mineralcorticoid properties, directly contributes to accelerate renal damage through promotion of cell growth, fibrosis and inflammation. As a consequence, attenuation of growth-promoting and fibroproliferative effects of aldosterone might contribute to slow progression of chronic renal injury. Preliminary clinical observations have documented that aldosterone blockers added to angiotensin-converting enzyme inhibitor- and/or angiotensin receptor blocker-based regimens exerted significant antiproteinuric effects in patients with diabetic and nondiabetic nephropathies. Further studies in larger cohorts are now required to definitively address the safety and efficacy of aldosterone antagonism in patients with chronic kidney diseases.

Key Words: aldosterone, chronic kidney diseases, proteinuria, glomerulosclerosis, hyperkaliemia, tubulo-interstitial injury

First published on January 26, 2009, doi:10.1177/1753944708100409

Therapeutic Advances in Cardiovascular Disease 2009;3:133.

A more recent version of this article appeared on April 1, 2009

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